ABSTRACT/PROJECT SUMMARY - OVERALL COMPONENT Children with pediatric rheumatic and non-inflammatory musculoskeletal diseases (PMSKD) have an urgent need for evidence-based medical care that considers the striking differences between pediatric and adult populations. To address these gaps in scientific knowledge, we propose to establish a Pediatric musculOskeletal & RheumaTology Innovation COre center (PORTICO) at the Cincinnati Children' Hospital Medical Center. Objectives of PORTICO will be to promote impactful research in PMSKD, locally and nationally, with a focus on our well-established research programs in juvenile arthritis, lupus and juvenile fibromyalgia. Specific Aims are: Aim 1: To promote innovation and support clinical research with advanced data science, data analytics capabilities, and data pipeline development. Aim 2: To invigorate cross-disciplinary team science of the local but also national community of researchers in PMSKD. Aim 3: To enhance research in PMSKD by developing and offering cutting-edge assessment tools for capturing the benefits of health interventions and delineating PMSKD phenotypes. Advanced imaging services to support PMSKD research (ultrasonography, magnetic resonance imaging, biomechanical assessment) will be provided, new imaging-based methods and scoring systems developed and an interactive dashboards to synthesize information from patient reported assessments, imaging data, novel biomarkers and traditional disease measures developed in support of improved shared medical decision making. Expected result: PORTICO will create a vibrant research environment that fosters productive team science to find answers to important scientific unknowns regarding PMKSD. Innovation will be sought by (1) developing diagnostics for PMSKD (laboratory tests, imaging tests) and testing their integration into clinical care, and (2) advancing evidence-based based therapies, with focus on JIA, cSLE and JFM. Spread of PORTICO findings and increase of the local & national Research Community will be achieved by multisite research studies, PORTICO's Outreach Program, and its Pilot & Feasibility Studies Program. Alignment with the efforts of other CCCRs, other organizations involved in PMSKD research, and the local research environment is anticipated to potentiate spread of ideas and innovation by PORTICO investigators